‘Patients are suffering the consequences of a system that is in crisis’ – RCEM responds to CQC’s UEC patient survey

Thursday 21 November 2024

Patients are suffering the consequences of an Urgent and Emergency Care system that is in crisis.

That’s the response of the Royal College of Emergency Medicine (RCEM) to the findings of the Care Quality Commission’s (CQC) latest survey about people’s care and treatment experiences in NHS Urgent and Emergency Care (UEC) services in England.

The 2024 Urgent and Emergency Care Survey captured the views and experiences of more than 45,500 people, aged 16 and over, who sought care in either an A&E department or an Urgent Treatment Centre (UTC) in February this year (2024).

The survey asked people to give their opinions on the care they received, covering areas such as the long waits they had to endure, ambulance handover delays and communication with staff about their condition.

It found:

• 74% of patients weren’t told how long they would have to wait in A&E to be examined or treated.
• 64% of patients waited more than four hours to be admitted, transferred or discharged at A&E, and patients whose visit lasted more than four hours reported worse than average experiences for all areas of care analysed.
• Of the 27% of respondents who arrived at A&E by ambulance, 61% were handed over to A&E staff within 15 minutes, but 17% reported waiting more than an hour. Over a quarter of Type 1 patients (28%) waited for more than an hour to be assessed by a nurse or doctor after arriving, while 47% said they were not able to get help with their condition or symptoms while waiting.
• 60% of respondents who attended A&E felt that doctors of nurses ‘completely’ explained their condition or treatment to them in a way they could understand. 28% said this only happened ‘to some extent’ and 11% said it didn’t happen at all.
• One in five (21%) people discharged from an A&E department said that they were not told who to contact if they were worried about their condition or treatment after leaving A&E.

Despite the negative elements, more than a third (38%) of respondents who attended A&E rated their overall experience as nine or higher out of 10.

Dr Adrian Boyle, President of The Royal College of Emergency Medicine said: “This is a vital piece of patient-centered work, that offers a glimpse into their experiences of Urgent and Emergency Care through their eyes.

“It paints a clear picture and reinforces what RCEM has been saying – patients are suffering the consequences of a system that is in crisis, while staff continue to shoulder the burden of delivering effective and safe care in these conditions.

“Issues within and outside the Emergency Department are negatively impacting patient’s experiences, as seen in this survey, with a high proportion enduring long wait times due to the lack of in-patient beds and inability to discharge people who are well enough to go home.

“No ED clinician wants to be treating a patient who is vulnerable and in need of care in a corridor and no patient wants to be put in this position. It’s degrading, demoralising and dangerous.

“While it is encouraging to see the majority of people were positive about their interactions with staff, we still have some way to go in ensuring we effectively communicate with patients about their health. No one should be leaving our departments with no understanding of their journey and next steps in their care.

“The pressure in EDs will only continue to mount as we head into winter, when we know the inevitable spike in demand will hit.  Those in power need to read the results of this survey, hear the voices of the patients who have expressed their experiences and concerns, and act on them now.”

This report also revealed that the inability to get a GP appointment quickly enough and wanting to be seen on the same day directly influenced people’s decisions to seek treatment at a UEC service.